I feel anxious and cannot sleep post-partum. What can I do?

Question

Hello doctor,

I am 28 years old. I had a C-section delivery last month, and I am feeling anxious all the time and have constipation, for which I took Freelac syrup. Also, I had pain in the lower back, left side, for which I had to go to the hospital and get an injection, and then I was relieved.

After the pain, my anxiety and sleep problems elevated. I am unable to sleep even if my baby is sleeping.

Please suggest what I can do.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

At about three to four weeks after a C-section, constipation is quite common, and using lactulose syrup (Freelac) is fine. The more concerning issue from your history is the anxiety, inability to sleep, and how it worsened after the back pain episode.

This pattern suggests postpartum anxiety with insomnia, which is not unusual after delivery when hormones are still settling and you’re coping with the demands of a newborn.

The fact that you cannot sleep even when the baby sleeps indicates it is more anxiety-related than just baby-care disturbance. The likely cause is a mix of hormonal changes, physical stress from surgery, and anxiety triggered by the pain episode.

For now, you can get basic investigations like CBC (complete blood count), thyroid profile, vitamin D, and calcium. Other tests can be considered if fatigue or mood issues continue.

Other possibilities include postpartum depression, thyroid imbalance, or rarely a medication side effect, but the most likely diagnosis is postpartum anxiety with insomnia. You should continue iron and calcium as prescribed. Follow the suggestions below:

For constipation, keep using syrup if needed, and add fiber through fruits, vegetables, and fluids.
For anxiety and sleep, follow a regular sleep–wake routine, try relaxation techniques like warm baths or gentle breathing, and avoid too much tea or coffee.
If sleep does not improve, it is important to see your doctor. Sometimes short-term, safe medication is needed, but it must be prescribed after evaluation.
Sharing your feelings with family and getting help with baby care will also ease the pressure.

Also, update if constipation continues despite the syrup or if back pain returns. Do not ignore anxiety or sleep issues as they may worsen; instead, take breaks, include light activity like walking, and maintain good nutrition.

Please visit your doctor if you experience persistent low mood, hopelessness, inability to care for your baby, or if anxiety does not improve within a week.

I hope this helps.

Thank you.